Biopsy mapping tools

ABSTRACT

Apparatus for plotting pathological diagnoses on anatomical diagrams is provided. The apparatus may include a mapping tool. The mapping tool may identify a plurality of biopsy marker records including a received criterion. The mapping tool may identify a body part image associated with a body part image ID. The mapping tool may section the body part image into a first quadrant and a second quadrant. The mapping tool may loop through the plurality of biopsy marker records to identify an X,Y coordinate associated with each of the plurality of biopsy marker records. For each X,Y coordinate identifying a location within the first quadrant, the mapping tool may iteratively tally a first count for the first quadrant. For each X,Y coordinate identifying a location within the second quadrant, the mapping tool may iteratively tally a second count for the second quadrant.

PRIORITY DATA

This application is a continuation of U.S. patent application Ser. No.16/403,715, filed on May 6, 2019, which is a divisional of U.S. patentapplication Ser. No. 14/707,902, filed on May 8, 2015, which is anonprovisional of U.S. Provisional Application No. 61/990,844, filed onMay 9, 2014, all of which are hereby incorporated herein by reference inits entirety their entireties.

FIELD OF TECHNOLOGY

This invention relates to apparatus and methods for plottingpathological diagnoses on anatomical diagrams. The apparatus includes amapping tool. The mapping tool may retrieve one or more electronicrecords. The mapping tool may use the electronic records to generate ananatomical diagram including a symbol associated with a pathologicaldiagnosis.

BACKGROUND OF THE DISCLOSURE

Typical pathology lab reports describe, in words, a location of a biopsysample (or other clinical finding or test result) and relatedinformation such a diagnosis and treatment. If two or more biopsies aretaken on different calendar dates, separate lab reports are usuallygenerated for each biopsy.

This is not desirable at least because a health professional is requiredsift through the text of the report, and sometimes the text of multiplereports, to become familiar with a patient's medical history. It alsomay be difficult for a report reader to conceptualize a specialrelationship among various diagnoses from different time periods andassociated with different locations on a patient's body.

It is desirable, therefore, to provide systems and methods fordisplaying pathology or clinical data in an interactive format thatallows a user to view, at a glance, multiple medical events for one ormore patients. This is desirable at least because viewing medical datacollected over time provides a quick, accurate and understandableperspective on the collected data.

For example, a typical pathology lab report may describe, in words, alocation of a biopsy sample and related biopsy information such adiagnosis and treatment. If two or more biopsies are taken on differentcalendar dates, separate lab reports are usually generated for eachbiopsy.

It may be difficult for readers of the lab reports to correlate the textof the lab report to locations on a patient's body referred to in thelab report text. A reader of the lab report may misread or misunderstandtext included in the lab report. A reader of the lab report may beunable to locate, on the patient's body, a location referred to in thetext of the lab report.

It would be desirable to present medical information such as clinicalfindings, lab report or test results in a visual format. A visual formatmay allow a viewer of the visual report to easily conceptualizediagnoses and locations referenced in the medical information. Forexample, a visual report of laboratory diagnostic information may allowa viewer of the visual report to more easily associate contents (such asdiagnoses) of the visual report to locations on a patient's body.

Additionally, a visual report may include an overlay, on a body partimage, of historical lab reports associated with a patient over a periodof time. A visual display of the historical lab reports may allow aviewer of the lab reports to quickly, accurately and easily understand apatient's clinical history.

Effective Apr. 7, 2014, a new federal ruling issued by the Centers forMedicare Medicaid Services (Federal Register Number: 2014-02280) nowallows patients to access their test results directly from thelaboratories in which their testing was performed. Current lab reportsare not suited for the general public to understand quickly andaccurately.

It is further desirable, therefore, to provide systems and methods forenabling patients, without prior medical training, to view theirpathological history and diagnoses superimposed on a diagram thatdisplays an image of a body part. This is desirable at least becausesuch diagrams are easy to understand and allow patients to immediatelyverify that their biopsies were taken from the correct parts of theirbodies, enhancing patient satisfaction and security. Visual display ofmedical information may also allow a viewer to see a spatialrelationship among various diagnoses or clinical findings associated oneor more body locations.

SUMMARY OF THE DISCLOSURE

Apparatus and methods for plotting pathological diagnoses on one or moreanatomical diagrams are provided. Methods may include receiving anelectronic communication containing an accession number. An accessionnumber may be a chart number or other identifier associated with apatient's medical records. Methods may also include running a firstquery to return, from a database, a plurality of biopsy marker recordsthat include the accession number. Each biopsy marker record may includemedical information associated with a clinical assessment of a patient.The medical information may include a clinical assessment associatedwith a body surface, such as a result of a biopsy taken from thepatient's skin. The medical information may include a clinicalassessment associated with an internal organ of the body, such as ablood test or a liver biopsy. In response to receiving the plurality ofbiopsy marker records, the methods may further include running a secondquery to return a body part image ID associated with the plurality ofbiopsy marker records. The methods may also include retrieving a bodypart image associated with the body part image ID.

Methods may further include iterating through the plurality of biopsymarker records to identify an overlapping X,Y coordinate associated withtwo or more of the plurality of biopsy marker records. Methods may alsoinclude identifying a subset of biopsy marker records, each of thebiopsy marker records included in the subset being associated with theoverlapping X,Y coordinate. Methods may additionally include iteratingthrough the subset to identify a pathological diagnosis associated witheach of the biopsy marker records included in the subset.

Methods may further include querying an electronic record storing ahierarchy of pathological diagnoses and, based on the hierarchy,identifying an optimized pathological diagnosis associated with each ofthe biopsy marker records included in the subset. The optimizeddiagnosis may identify the most serious diagnosis associated with thesubset. Methods may also include generating a display on a graphicaluser interface (“GUI”), the display including at least a first symboland a second symbol overlaid on the body part image.

The first symbol may be associated with a first pathological diagnosis.The first pathological diagnosis may be included in a biopsy markerrecord that is not part of the subset. The second symbol may beassociated with the optimized pathological diagnosis. The second symbolmay be representative of the at least two biopsy marker records includedin the subset.

BRIEF DESCRIPTION OF THE DRAWINGS

The objects and advantages of the invention will be apparent uponconsideration of the following detailed description, taken inconjunction with the accompanying drawings, in which like referencecharacters refer to like parts throughout, and in which:

FIG. 1 shows an illustrative graphical user interface for use with thesystems and methods of the invention;

FIG. 2 shows another illustrative graphical user interface for use withthe systems and methods of the invention;

FIG. 3 shows yet another illustrative graphical user interface for usewith the systems and methods of the invention;

FIGS. 4A-4B shows yet another illustrative graphical user interface foruse with the systems and methods of the invention;

FIG. 5 shows yet another illustrative graphical user interface for usewith the systems and methods of the invention;

FIG. 6 shows yet another illustrative graphical user interface for usewith the systems and methods of the invention;

FIG. 7 shows yet another illustrative graphical user interface for usewith the systems and methods of the invention;

FIG. 8 shows yet another illustrative graphical user interface for usewith the systems and methods of the invention;

FIG. 9 shows yet another illustrative graphical user interface for usewith the systems and methods of the invention;

FIG. 10 shows yet another illustrative graphical user interface for usewith the systems and methods of the invention;

FIG. 11 shows yet another illustrative graphical user interface for usewith the systems and methods of the invention;

FIG. 12 shows illustrative computing apparatus for use with the systemsand methods of the invention;

FIG. 13 shows additional illustrative computing apparatus for use withthe systems and methods of the invention;

FIGS. 14A-14I shows an illustrative flowchart for use with the systemsand methods of the invention;

FIGS. 15A-15B shows another illustrative flowchart for use with thesystems and methods of the invention; and

FIG. 16 shows illustrative body part images for use with the systems andmethods of the invention.

DETAILED DESCRIPTION OF THE DISCLOSURE

Apparatus and methods for a mapping tool are provided. The mapping toolmay use historical data stored in electronic records and/or one or moredatabases to plot medical information on one or more anatomicaldiagrams. An electronic record may include any suitable medical data fora patient, detailing one or more diagnoses, clinical findings, medicaltests, procedures, illnesses, historical records, or any other suitablemedical data. In some embodiments, an electronic record may includebiopsy information.

The mapping tool may be used by one or more physicians, privatepractices, group practices, hospitals, laboratories, pharmaceuticalcompanies, healthcare researchers, military hospitals, governmentagencies, private and government-funded insurance providers or any othersuitable users.

In some embodiments, the mapping tool may access the electronic medicalrecords (“EMRs”) of patients of the mapping tool's users. An electronicmedical record may be a digital patient medical record used by a healthcare facility to store and update patient medical information.

In some embodiments, the mapping tool may be used by a first user of thetool to transmit medical data, such as EMRs or other data, to a seconduser of the tool. In some embodiments, the mapping tool may function asa central data repository of data for two or more users of the tool.Data stored by a first user of the mapping tool may be accessed by asecond user of the mapping tool, or may be accessibly only to the firstuser.

The mapping tool may store historical information, which may includehistorical medical information, in one or more databases. The data maybe input into the mapping tool by one or more users of the tool.Additionally, or alternatively, the mapping tool may source, receive,pull or search data from one or more of user databases or from any datarepository storing medical information for a population or any othersuitable data.

The mapping tool may incorporate a patient's stored historical data withan EMR associated with the patient, or store the patient's historicaldata across one or more databases. The mapping tool may use the at leastsome of a patient's data to create one or more electronic records forthe patient. An electronic record may be used to store data relating toa medical event in the patient's history. Electronic records created bythe mapping tool may be used to generate one or more repots. A reportmay include one or more images. A report may be integrated into thepatient's EMR. A report may assist a physician, or other view of thereport, to visually review a portion of a patient's medical informationquickly and accurately.

The mapping tool may generate an electronic display of medicalinformation. The mapping tool may generate display of medicalinformation on paper.

For example, in the practice of pathology, a laboratory or physician maytake a biopsy sample from an area of the human body. The area of thehuman body may include a lesion. A user of the mapping tool may inputhistorical data into the mapping tool relating to the patient, thebiopsy, the location of the lesion, and a pathological diagnosisassociated with the biopsy. Alternatively, the mapping tool may receiveand store the historical data in one or more databases. The mapping toolmay use at least a portion of the historical data to create anelectronic record for the patient. An electronic record including biopsyinformation may be referred to alternately herein as a “biopsy markerrecord.”

The apparatus and methods of the invention are described below in thecontext of biopsy data. Any other suitable medical data is includedwithin the scope of the invention. Other illustrative medicalinformation may include clinical finding, such as a skin lesion thatshould be observed during future visits, a body landmark, blood tests orradiology reports.

Exemplary historical data stored by the mapping tool for the patientincludes a numeric patient identifier, the patient's social securitynumber and the patient's date of birth, and a case or accession number.In some embodiments the mapping tool may receive the numeric patientidentifier and biopsy information, and issue a case or accession number.The accession number may be a chart number or other unique identifierassociated with a patient's medical information. The mapping tool mayassociate the patient's historical data with the accession number.

Additional exemplary historical data accessible by the mapping tool fora patient may include information identifying where on the human bodythe lesion was found. The mapping tool may use this information toidentify a location on a body part image stored in a body part imagedatabase. The identified location may correspond to the area of thehuman body where the patient's biopsy was found.

The body part image database may include a plurality of body partimages. A body part image may be an image of the human body. The bodypart image may be in 2D or 3D. The images may display an internalportion of the body, an external portion of the body, or the whole humanbody. Each body part image may be associated with a body part image ID.

In some embodiments, the mapping tool may store a location on a bodypart image as an X,Y coordinate or an X,Y,Z coordinate, and in someembodiments additional coordinates for three or more dimensional mappingand other features such as image rotation. The coordinates may identifya location on the body part image. The coordinates may identify alocation within a body organ. In other embodiments, the mapping tool maystore the location associated with the biopsy as a two-dimensional areadefined by X,Y coordinates. The two-dimensional area may identify anarea located on a body part image. In some embodiments, the mapping toolmay store information identifying a three-dimensional area using X,Y,Zcoordinates on the body part image from which the biopsy was taken.

In some embodiments, a user may input location data into the mappingtool by generating a display of a selected body part image andidentifying, using a touch screen or a mouse, the location on the bodypart image where the biopsy was taken. For example, by clicking on aportion of displayed image, a clinician may thereby identify a locationof a suspicious lesion or other clinical finding. The identifiedlocation may be displayed on a body part image to the clinician when thepatient returns for a follow-up visit. In yet other embodiments, themapping tool may receive text describing the body location where thebiopsy was taken. The mapping tool may use the text to identify the bodypart image and a location on the body part image where the biopsy wastaken from.

In other embodiments, an electronic diagram including an image of a bodypart and a marker identifying the location of the biopsy may beelectronically transmitted to the mapping tool. The image may be adiagram of at least a portion of the body that is different from thebody part images stored in the mapping tool's database(s). The mappingtool may use superimposition mapping techniques to fuse the image withan image stored in the mapping tool's database and identify the locationof the biopsy.

In yet other embodiments, the mapping tool may receive a photograph orimage of at least a portion of the patient. Exemplary photographs/imagesmay be a photograph of a patient, two/three dimensional diagramidentifying one or more biopsy locations such as results from an MRIscan, blood test and/or any other suitable clinical information. Thephotograph may include a marking on the skin where a biopsy will betaken/has been taken. The mapping tool may use superimposition mappingtechniques to correlate the photograph/image with a body part image andmap the marking on the skin onto a location of the body part image.

Exemplary superimposition mapping techniques used by the mapping toolmay include image recognition and photo fusion. The image recognitionmay comprise correlating the body part displayed in the photograph/imagewith a body part image in the mapping tool's database. Once the bodypart image is identified, the technique may include identifying, on thephotograph/image, one or more “match points.” Each body part image mayhave designated match points. For example, for the face, exemplary matchpoints may include top of the forehead, bottom of chin, nose, two sidesof mouth.

After identification of the match points, the mapping tool may use thematch points to center the mapping tool's body part image over thephotograph/image. After the body part image is centered on thephotograph/image, a lesion point or biopsy may be identified in thephotograph/image. The identified lesion point or biopsy may be mappedonto the body part image. The mapping tool may then assign a location tothe lesion point or biopsy, the location identifying the area on thebody point image where the lesion point or biopsy is found.

Additional historical data that may be input into the mapping toolincludes patient demographics, clinical history and data of the patientprovided by the physician, type of biopsy, depth of lesion, biopsyadequacy, biopsy methods, diagnostic testing, biopsy diagnosis,diagnostic category, diagnostic grading, tumor aggressiveness,recurrence rates, cure rates, treatments, treatment modalities, clinicalimpressions, detailed notes and patient insurance, payment information,discordance or concordance rates between diagnoses bypathologist/healthcare institution/technique, second opinion analyses,quality assurance analyses, insurance payments forinsured/uninsured/indigent patients and various types ofhealthcare-related cost analyses. It should be noted that any othersuitable historical data may be input into the mapping tool.

The mapping tool may store one or more pieces of patient historical datadetailed above in a new biopsy marker record or an existing biopsymarker record. The mapping tool may use biopsy marker records togenerate one or more repots. The reports may be displayed on a GUI.

An exemplary report generated for a patient's biopsy may display a bodypart image and a symbol. The body part image may be associated with abody part image ID stored in a biopsy marker. The body part image may bea visual image of the area on the human body from which the biopsy wastaken. The symbol may be overlaid on the body part image at a locationidentified in the record. The location may visually represent where onthe human body the biopsy was taken from. The symbol may visuallyidentify a diagnosis of the biopsy.

The mapping tool may select a symbol to be overlaid on a body part imagebased on diagnosis data associated with a biopsy. In some embodiments,each biopsy stored in a biopsy marker record may be associated with adiagnosis. The mapping tool may include a symbol record. The symbolrecord may include a plurality of diagnoses and a symbol associated witheach diagnoses. For each biopsy identified, the mapping tool mayidentify the associated diagnosis and search the symbol record toidentify a symbol associated with the diagnosis. The mapping tool maythen display the symbol at the location associated with the biopsy.

For example, the mapping tool may visual display a clinical findingsassociated with a liver superimposed on diagram of a liver. The clinicalfindings may include blood test results associated with the liver, aresult of biopsy taken from the liver, a portion of the liver marked forfuture medical observation and/or a finding extracted from a radiographor other medical image of the liver.

Symbols may be defined by color, shape, dotted lines, flashingindicators and more. Shapes and colors associated with a diagnosis maybe customized by a user. Exemplary shapes and colors for differentdiagnoses are included in Table 1 below.

TABLE 1 Symbol Color Diagnosis Shape Red Green Blue ● RED Cancer SolidCircle 255 0 0 Δ FUCHSIA Precancer Hollow Triangle 255 0 255

TEAL Suspicious Inverted Y 0 128 128 □ BROWN Benign Hollow Square 139 6919 x PURPLE Atypical “x” symbol 128 0 128 Y GREEN Infectious “Y” symbol0 128 0 ⋄ BLUE Inflammatory Hollow Diamond 0 0 255 − BLACK Negative Dash0 0 0

AQUA Other Irregular Pentagon 0 255 255 + ORANGE Positive Plus sign 255140 0 ~ BRIGHT Pin (prostatic Similarity symbol 192 192 192 GREENintraepithelial neoplasia)  ∩ GRAY Non-Diagnostic Arch 210 180 140

A symbol “C,” a circle with a question mark, or a flashing indicator maybe used to represent a conflict between labs about a diagnosis of abiopsy. A flashing indicator may be used to represent a biopsy that hasnot yet been treated, or a biopsy for which results have not yet beenreceived. A perimeter of a symbol may be turned into a dotted line ifthe margins of the biopsy site are not clear and more skin is requiredto be removed. A symbol “R” may be used to represent a biopsy diagnosedas rare and/or reportable.

In some embodiments, a color/shape of the symbol may represent thetreatment of the biopsy (e.g. excised, laser or medicated). In someembodiments, a confluence of symbols may be used to indicate more thanone test performed on a biopsy site, in addition to histology. Forexample, for each additional test, a line may be drawn through thesymbol associated with the site. User selection or placement of a mouseover the biopsy site displayed on a body part image may initiate thedisplay of a pop-up box including text detailing each of the testsperformed at the biopsy location.

A symbol displayed on a body part image may be associated with some orall of the historical information entered for the biopsy into the biopsymarker record. In some embodiments, selection of the symbol may initiatea display of at least a portion of the biopsy's historical information.In some embodiments, selection of the symbol may initiate a display of aphotograph taken of the biopsy location.

The mapping tool store information relating to one, two, three, or morebiopsies taken from a patient. Each biopsy may be associated with apatient identifier and/or an accession number. The mapping tool maycreate for the biopsies one or more biopsy marker records, includinghistorical information, as detailed above.

The mapping tool may store in one or more database(s) biopsy informationfor a plurality of patients. Biopsy marker records may be created foreach of the plurality of patients and stored in the database(s).Historical data stored in the biopsy marker records includes theexemplary historical data described above and any other suitable data.

The mapping tool may be used to generate a report for a patient or, asdetailed below, to display reports run by a user by selecting one ormore search terms of criteria. For example, when a biopsy diagnosis isfinalized by a lab, or a search is finished running, the mapping toolmay generate a report. The generated report may be in any suitableelectronic form, such as PDF (portable document format), Word documentor Excel or any other suitable format. The report may be stored,integrated and/or transmitted into the patient's EMR, a physician's EMRsystem, the patient himself/herself, printed in hard copy, ortransmitted in any other suitable fashion.

If the report is to be faxed in black and white, the report may usesymbols to distinguish diagnostic categories or other criteria.Exemplary symbols include cancer—solid circle, precancer—hollowtriangle, suspicious—plus sign and benign—hollow square.

In the embodiments where the report is generated for a single patient,the report may display some or all of the biopsies taken from thepatient. The biopsies may be biopsies taken on a single date or overtime. In the event that the report includes information relating to twoor more biopsies taken from a single body part, the report may include adisplay of a body part image representing the body part and symbolsrepresenting each of the biopsies overlaid on the body part image. Ifthe two or more biopsies were taken from different areas of the body,the report may include a display of each body part from which a biopsywas taken or an image of the entire human body with biopsy informationdisplayed thereon.

Reports generated by the mapping tool may include one or more datafields and functionalities. For example, reports generated by themapping tool may include a chart. The chart may include informationdetailing characteristics of biopsies displayed in the report. Exemplaryinformation includes a date on which a biopsy was taken, an accessionnumber associated with the biopsy, a location on the body where thebiopsy was taken, the symbol associated with the biopsy, a categoryassociated with the diagnosis, and the diagnoses. The chart may becustomized by a user to display any suitable historical data. In someembodiments, the chart may be customized by a user to display userselected information.

In some reports generated by the mapping tool, selection of a symboldisplayed on the body part image may highlight a row in the chart thatincludes information (e.g. a diagnosis) associated with the biopsy takenat the location where the symbol is displayed.

In some reports generated by the mapping tool, selection of a symboldisplayed on the body part image may initiate a pop-up box displaying anactual photo taken of the biopsied area.

A user may access the mapping tool to run one or more searches. Forexample, the mapping tool may be accessed online by the user. After asecure log in, the user may search the database(s) using one or moresearch terms.

The mapping tool may search the database(s) to retrieve some or allbiopsy data for a patient for any suitable time period or data onmultiple patients filtered by category, diagnosis, site and any othercriteria tied to the biopsy site. The mapping tool may search byaccession number, patient identifier, or using one or more terms and/orcriteria.

Exemplary search terms that may be used by the mapping tool to searchthe database(s) include searching the history of a single patient, aplurality of patients, or all patients based on one or more criteria.Exemplary criteria include data range (e.g. show all dates or select adate range), male/female, diagnosis (show all biopsies or choose bydiagnosis—customizable: Cancer only, Cancer and Precancer, Infectiousonly), category of diagnosis (e.g. cancer can be broken down by type,into melanoma, Basal Cell Carcinoma, Squamous Cell Carcinoma), test type(e.g. Histology, FISH (skin, breast, prostate, esophagus) or MolecularGenetics), body part, body location (Example: Right, Left and otherlocations), site, laboratory, insurance of patient, whether or not atreatment has been paid for, physician, practice, and geographical areaof patient(s) (e.g. county, town, state, country). Search terms may becustomized by the user.

The mapping tool may run the search created by the user. The mappingtool may use the results of the search to generate one or more reports.The reports may illustrate various types of information. The reports mayinclude diagnostic information overlaid on one or more body part images.

The tool may allow a user to customize the generated reports fordifferent types of end users. Illustrative end users may include apatient, a physician, laboratory and/or insurance company. For example,a user may select a body part image to be used on a report fordisplaying biopsy information. A user may also select image size,information to be included on data charts, and other features that canbe customized on reports. A user may also select an option for a reportto include, on a first page, an image in small font embedded in text,and the same image displayed again, in large font, on a following page.

The diagrams generated by the mapping tool may be used for quickreference, downloaded and saved in a patient's EMR, or used in apresentation or study.

A report or body part image generated by the mapping tool may includeany of the functionalities described in the application.

A report or image generated by the mapping tool may include a noteadding feature. The note adding feature may enable a user to add one ormore text boxes to the report/image. The user may add a text box byselecting the note tool, clicking on an area of interest, and typingtext. The text box may point to the selected area of interest. The textbox may visually identify to a user a location on the body that needs tobe watched more closely. A user may add an “eye” symbol, or otherindicator, to his note or to the image itself, alerting medicalpersonnel to ‘keep an eye on this.’

A selectable option in the mapping tool may include instructing themapping tool to display all notes associated with a report or image, orto display all notes created during a predetermined time span.

A report or image generated by the mapping tool may include a “zoom-in”function and a “zoom-out” function. The zoom-in and zoom-out functionmay be used at any location on a displayed report/body part image.

The zoom-in function may enable a user to further distinguishoverlapping biopsies (or other illustrative clinical findings), biopsylocations, or biopsy locations that are close together. In someembodiments, the zoom-in function may be automatically activated if auser places his mouse over a location of overlapping biopsies.

A report or image generated by the mapping tool may display a body partimage or any other image or photograph in 2D or 3D.

A 3D image displayed by the mapping tool may include visual indicatorsof biopsies, or other clinical findings, taken at different locationsaround the 3D image. A 3D image displayed by the mapping tool may be animage of the entire human body, a portion of the human body, or one ormore internal organs of the human body such as the colon,gastrointestinal (“GI”) tract—upper/lower, prostate and other internalorgans. In some embodiments, the mapping tool may use one or more of 3Dimage guided surgery and computerized axial tomography (“CAT”) scans tocreate the 3D image(s).

In the embodiments where the body part image or any other image or photois displayed in 3D, the mapping tool may include one or more interactivefunctionalities. For example, a user may rotate, pan, tilt and/or flipthe image by clicking and dragging a mouse, using a touch screenmonitor, or any other suitable methods.

A report or image generated by the mapping tool may display a body partimage or other image or photograph in a transparent form. Thetransparent form may enable a user to view both a front and back portionof the body part image simultaneously. This transparency may assist auser in identifying where biopsies have been taken in organs such as thecolon which has a tubular structure. Biopsies may displayed on the frontwall, back wall, top or bottom of the transparent image.

The mapping tool may include one or more functionalities allowing a userto sort data and/or display data on two or more body part images. Thedata may be data retrieved using one or more search criteria describedabove.

For example, two or more body part images (referred to alternatelyhereinafter as “layers”) may be generated to display subsets of dataincluded in a data set of medical information. This may provide a viewerwith in a visually display/sorting of search results in an easy tounderstand format. Exemplary criteria may include time period (e.g.current year, 1 year, 2 years, 5 years, all years), treatments (displaywhich biopsies were treated), laboratories, sites, payments and otherdata. For example, a user may want to view all biopsies performed on apatient. A user may then select three different time periods. Themapping tool may then display three body part images, each body partimage displaying biopsy data for the patient that was taken during oneof the three different time periods.

Layers may be added or removed by a user by checking and uncheckingcriteria. Unchecking criteria may result in overlaying two or morelayers and merging together the coordinates of symbols displayed on thedisplayed overlaid layers.

The mapping tool may include one or more functionalities for displayingbiopsies, or other clinical data, on a body part image which are closein proximity to one another, or directly on top of each other.

In some embodiments, the mapping tool may display an arrow pointing tooverlapping biopsies. In some embodiments, the overlapping biopsies maybe identified by a flashing circle. In some embodiments, the overlappingarea may be darker relative to other areas on the body part image. Insome embodiments, the mapping tool may display a symbol on theoverlapping site. In some embodiments, overlapping symbols may bedisplayed. In some embodiments, a flashing box may highlight theoverlapping biopsy site. In some embodiments, the symbols for eachoverlapping diagnosis may flash alternately on the overlapping site. Thedisplayed symbol may represent the most severe diagnosis associated withthe biopsies located at the overlapping site.

The mapping tool may generate a visual display of medical informationbased on a hierarchy of pathological diseases. The hierarchy may rankpathological diseases by severity of diagnosis, urgency of treatment, orany other suitable criteria. In the event that the mapping toolidentifies two or more overlapping biopsies, the mapping tool may usethe hierarchy to identify an optimized pathological disease. The mappingtool may identify the optimized pathological disease by identifying,from a group of pathological disease associated with the overlappingbiopsies, a pathological disease that is associated with the highest orlowest ranking value on the hierarchy relative to the other pathologicaldiseases in the group.

The mapping tool may display, next to the overlapping site or on top ofthe overlapping site, a numerical value equal to the number of biopsieslocated at the overlapping site.

Placement of a cursor, or user selection of the overlapping site, mayilluminate or generate diagnosis and diagnostic information on a chartassociated with each of the biopsies located at the overlapping site.

For example, the mapping tool may include one or more functionalitiesfor displaying a single biopsy with one or more diagnoses. In someembodiments, a symbol representing the more serious biopsy diagnosis maydisplay at the site. Other functionalities may include thefunctionalities used by the mapping tool for displaying biopsies on abody part image which are close in proximity to one another, or directlyon top of each other.

The mapping tool may include a recurrence alert. The recurrence alertmay alert a user of the mapping tool of areas of a patient's body whichhave a greater chance of developing cancer or other diseases.

The mapping tool may implement the recurrence alert by comparing alesion size/volume and/or a distance between a lesion and other lesionsnearby with pre-established measurements. The measurements may be basedupon scientific findings and integrated with published data proven toindicate, or correlated with, a recurrence. The mapping tool may runthis alert for each biopsy displayed on a body part image. If one, twoor more biopsies are found to be at risk for recurrence, the mappingtool may highlight the biopsies and/or areas around the biopsies thatare at risk for recurrence.

For example, an image of a face may include a biopsy removed from theface. The recurrence alert may assess the length (1D), length and width(2D), or length, width and depth (3D) of the biopsy, and any otherbiopsies displayed on the face. Based on the 1D, 2D or 3D measurementsof the biopsy and the other biopsies, the recurrence alert may searchfor previous biopsies within a 5 mm radius of the current biopsy.

The mapping tool may include “hot spot mapping.” Hot spot mapping may beused to display the results of searches identifying clinical findingstaken from multiple locations on a body part image. Hot spot mapping maybe used to display the results of searches identifying clinical findingsassociated with a population. Hot spot mapping may be a user selectableoption. In some embodiments, a search may default to hot spot mapping ifmore than a threshold number of clinical findings are associated with abody part image displayed by the mapping tool.

A user may run a hot spot search using the mapping tool by selecting oneor more criteria to be applied to any suitable data set accessible viathe tool. For example, a user may search the data set by type of cancerand patient demographics such as age, race and/or risk factors such assmoking and/or genetic predisposition.

The mapping tool may then identify a body part image associated with thesearch. The mapping tool may section the body part image into quadrants.In some embodiments, the quadrant sectioning may be correlated with theICD-9 body part descriptions or any other suitable description orspecification. ICD-9 is the International Classification of Diseases,Ninth Revision, Clinical Modification system used by health careproviders to classify and code diagnoses, symptoms and proceduresrecorded in conjunction with hospital care in the United States.

The mapping tool may loop through all the biopsy marker recordsidentified in the search and tally how many biopsies were found in eachof the quadrants. If a biopsy has a boundary between two quadrants, thebiopsy may be assigned to the quadrant in which a majority of the biopsyarea is located. If the biopsy is located exactly in the middle of twoquadrants, the mapping tool may alternate assigning of the biopsy to oneof the two quadrants.

The generated image may color each quadrant based on a number ofbiopsies found in each quadrant. Two or more colors may be used for theshading. Each color may identify a numerical range of biopsies that arelocated in a quadrant shaded by that color. For example, a shading ofdeep red, light red and pink may be used, with each color representing apredetermined range of biopsies.

For laboratories that do not use diagrams, a text-to-plot system may beused by naming quadrants with site names that the laboratory uses suchas upper left cheek, lower right chin and others. The biopsies may thenbe confined to that quadrant and the color range system may be applied(e.g. deep red—light pink/high quantity—low quantity, respectively) orthe number of biopsies can display within the quadrants.

At set forth above, the mapping tool may be used to run a plurality ofsearches and generate a wide range of images and reports. Additionalexemplary searches and reports executed by the mapping tool are detailedbelow.

In some embodiments, the mapping tool may be used to search forinstances of discordance between two or more labs (i.e. when a secondconsultation from a lab resulted in a different diagnosis). This searchmay be modified by one or more criteria identified above. For example,selection of a “show conflicts” option may present a user with searchoptions such as viewing conflicts by site, by laboratory, by diagnosis,by body part, and any other suitable criteria. If multiple labs areselected and displayed on a single diagram, medical test resultsgenerated by different laboratories may each be differentiated by colorand/or symbol.

In some embodiments, the mapping tool may be used to track improperspecimen handling by site. Examples of improper specimen handlinginclude site mismatch, name mismatch, submitted in expired media,submitted in incorrect media (e.g. formalin versus ThinPrep), andinadequate specimen (e.g. not enough sample from patient or not enoughremoved). These problems can be differentiated by color/symbol ormixture of both. The mapping tool may allow a user to filter problemdata by site, by physician, practice, lab and any other suitable data.Selection of a biopsy, or other indicator displayed on body part image,may initiate a display of a text box including more information such assite of specimen taken and problems with specimen.

In some embodiments, the mapping tool may be used by a group practice tooptimize treatment plans. For example, a search may be run by searchingall clinical data associated with a group practice and generating adiagram displaying all of the group's biopsies, treatments and results.This report may enable the group practice to streamline methods andtreatments based on effectiveness.

In some embodiments, the mapping tool may use historical data todetermine the effectiveness of one type of treatment in comparison to asecond type of treatment. For example, symbols, colors and highlightingoptions, may be selected by a user of the mapping tool to display datafor patients with cancer treated with “A” procedure/treatment/techniqueand to display and compare results to patients treated with “B”procedure/treatment/technique. A special symbol may appear on thediagram where each biopsy was taken, and the symbol may be highlightedif that site had a lower complication rate and/or higher cure rate ofcancer. This may assist the practice in visualizing whether acomplication/cure is more frequent on certain parts of the bodydepending upon which treatment modality was used or if a lack ofeffectiveness by treatment is responsible for a complication or cure.

For example, Mohs Micrographic Surgery (MMS) is a highly specializedtreatment method used to remove two of the most common skin cancers,Basal Cell Carcinoma (BCC) and Squamous Cell Carcinoma (SCC) whilesalvaging as much healthy tissue as possible and leaving minimalscarring on sensitive areas such as the face. This treatment has thehighest cure rate and is performed in one day allowing for patients torecover quickly. A new study released by the American Academy ofDermatology in 2012 evaluated the use of Mohs surgery and updated itscriteria on which lesions it should be used for based on factors such asarea of body, lesion size, patient characteristics and tumorcharacteristics. An article published by the New York Times in January2014 investigated the overuse of Mohs surgery and found that physiciansperformed this method of removal over 400 percent more than a decade agoprompting Medicare to add it to the top of their list of “potentiallymisvalued” overused or overpriced procedures.

The mapping tools may be used to display areas on the body in which Mohsis appropriately or inappropriately used. The selectable criteria can besuperimposed on a desired body location/image to differentiate proper orimproper use on the selected body location. For example, in someembodiments, the mapping tool may include one symbol for excision and adifferent symbol for a Mohs procedure. If the symbol is hollow, thetreatment cured the patient. If the symbol is filled in, the treatmenthad complications. Thus, the mapping tool can be used to illustratewhether or not Mohs has more cures and less complications in comparisonto excisions.

In some embodiments, the mapping tool may be used to identify whichbiopsies, or other clinical procedures, have been paid for, have notbeen paid for yet by an insurance company, or which biopsies have notbeen paid for yet by all insurance companies. The tool may identify atrend by insurance companies and put procedures in place to follow upwith those insurance providers that lag in payment by diagnosis or othercriteria.

In some embodiments, the mapping tool may be used to identify trends inwhich certain biopsies or other clinical procedures, take the longest tobe reimbursed. For example, a user of the mapping tool may identify,using one or more diagrams output by the mapping tool, that prostatebiopsies take longer to be reimbursed because there of discrepanciesrelating to the amount of biopsies that need to be taken, or because ofmissing information.

In some embodiments, the mapping tool may be used to create one or morereports that assist a user in identifying unnecessary test(s) orderingby site or costly techniques used by a physician when a less invasive,less expensive method of removal or treatment could have been performed.For example, a user may run a report in the mapping tool that displayswhich physicians used invasive techniques for non-invasive conditions ordiscordance of treatment versus technique according to published data.These results may be viewed overlaid on a body part image by biopsylocation, patient insurance, treating physician or any other suitablecriteria.

In some embodiments, the mapping tool may be used to create one or morereports to assist a user in identifying which physicians or practicestake more biopsies based on patient insurance. For example, a user mayuse the mapping tool to run a report by searching the criteria“biopsies” and “insurance plan,” and customize the biopsy displays to berepresented by color/symbol associated with an insurance plan/provider.The report may be viewed on one diagram. The report may include manylayers, each layer being associated with an insurance plan and, in someembodiments, a body image.

In some embodiments, the mapping tool may be used to create one or morereports to visually display, for a particular body part, which labsdiagnose cancer more frequently than other labs by location, bysearching by diagnosis and laboratory. The search results may beoverlaid on a body part image. This information may be useful forinsurance companies at least because over-diagnosing by a laboratorydesiring to ingratiate themselves with a physician or practice cansignal fraud or abuse as the doctor will receive more money based on adiagnosis of cancer (Preventing over diagnosis: how to stop harming thehealthy. BMJ2012; 344:e3502.)

The mapping tool may also be used to display a number of biopsies orother clinical procedures, performed by a medical practice based on apatient's insurance status (insurance provider, self-pay, uninsured orindigent patients). In some embodiments, each biopsy taken may bedisplayed by a symbol associated with the insurance of the patient. Areport generated may include a single image with all biopsy data or aseparate image for each insurance status. Trends in increase of biopsiesor testing by type of patient insurance, or lack thereof, can signalpossible abuse by physicians because insurance carriers pay differentlyfor certain procedures and tests performed.

In some embodiments, the mapping tool may be used by healthcareresearchers to identify any increase in cancer incidence, or changes incancer incidence, on a particular site by gender, race, age,geographical area. Society would then possible be able to counteractthis cancer trend through education and other appropriate measures. Themapping tool may also be used by healthcare researches to identify hotspots. Furthermore, the mapping tool may enable a user to identify andview recurrence rates or cure rates by site, by method of treatment, byage and/or gender or any suitable demographic criteria.

Benefits include quickly identifying trends in cancer, precancer andother diseases, biopsy adequacy, concordance rates and the mosteffective treatments for patients while reducing healthcare costs at thesame time. The mapping tools may be implemented to standardize labreporting methods nationally and achieve complete integration ofinformation among a plurality of laboratories, or all laboratories. Thistechnology can be adopted into any healthcare establishment andcustomized to their specifications.

One of ordinary skill in the art will appreciate that the steps shownand described herein may be performed in other than the recited orderand that one or more steps illustrated may be optional. The methods ofthe above-referenced embodiments may involve the use of any combinationof methods, portions of methods, partially executed methods, elements,one or more steps, computer-executable instructions, orcomputer-readable data structures disclosed herein. Embodiments mayinclude printing, on paper, visualization of diagnoses on a body partimage.

As will be appreciated by one of skill in the art, the inventiondescribed herein may be embodied in whole or in part as a method, a dataprocessing system, or a computer program product. Embodiments disclosedherein may be partially or wholly implemented on a computer-readablemedium, for example, by storing computer-executable instructions ormodules or by utilizing computer-readable data structures. Accordingly,the invention may take the form of an entirely hardware embodiment, anentirely software embodiment or an embodiment combining software,hardware and any other suitable approach or apparatus.

Furthermore, such aspects may take the form of a computer programproduct stored by one or more computer-readable storage media havingcomputer-readable program code, or instructions, embodied in or on thestorage media. Any suitable computer readable storage media may beutilized, including hard disks, CD-ROMs, optical storage devices,magnetic storage devices, and/or any combination thereof. In addition,various signals representing data or events as described herein may betransferred between a source and a destination in the form ofelectromagnetic waves traveling through signal-conducting media such asmetal wires, optical fibers, and/or wireless transmission media (e.g.,air and/or space).

Illustrative embodiments of apparatus and methods in accordance with theprinciples of the invention will now be described with reference to theaccompanying drawings, which form a part hereof. It is to be understoodthat other embodiments may be utilized and structural, functional andprocedural modifications may be made without departing from the scopeand spirit of the present invention.

FIG. 1 shows an illustrative portion of report 100 generated by themapping tool. Report 100 includes body part image 103. Body part image103 includes three symbols from three different dates of serviceoverlaid on top of body part image 103. It would be difficult to realizethe special relationship amount the diagnoses represented by the threesymbols without the superimposition of the diagnoses on body part image103. Legend 105 details a diagnosis associated with each of the threesymbols.

A mouse is displayed overlaid on report 100. Placement of the mouse overof the cancer symbol displayed on body part image 103 is shown togenerate gross image 107. Gross image 107 is a photograph taken of thecancer site prior to a biopsy. Placement of the mouse over the displayedbody part image 103 is also shown to generate chart 109. Chart 109includes the following columns: date 111, accession number 113, site115, symbol 117, category 119, diagnosis 1221 and customized columns123. The columns in chart 109 are populated with data associated witheach of the symbols overlaid on body part image 103.

It should be noted that, in other embodiments, when a mouse is placedover one of the symbols overlaid on body part image 103, chart 109 mayhighlight a column in the chart that includes information describing the“placed over” symbol. In yet other embodiments, when a mouse is placedover one of the symbols overlaid on body part image 103, a chart may bedisplayed that includes information only relating to the “placed over”symbol.

FIG. 2 shows an illustrative portion of one or more reports that may begenerated by the mapping tool. The report shown in FIG. 2 illustrates abody part image representing a colon of a patient. The patient has hadthree biopsies taken from the colon on Mar. 14, 1998, Dec. 1, 2003, andMay 22, 2014. Each biopsy has been diagnosed.

Body part images 201, 203 and 205 illustrate images generated by themapping tool. The images may be generated by the mapping tool inresponse to a user selection to view the biopsies separately byselecting date of service or any other suitable user selection. Each ofbody part images 201, 203 and 205 show information relating to a biopsy.The biopsy information illustrated in each of body part images 201, 203and 205 is conveyed to the user at least by (1) displaying a symbolassociated with the diagnosis of the biopsy and (2) displaying thesymbol in the location where the biopsy was taken. Legend 209 includestext informing a user of the diagnosis associated with each of thesymbols.

Body part image 207 illustrates an image generated by the mapping toolin response to a user selection to view all biopsies on a single bodypart image or any other suitable selection. Body part image 207illustrates all three biopsies taken for the patient layered on a singleimage.

FIG. 3 shows illustrative functionalities of the mapping tool. Body partimage 301 represents a front view of a colon of a patient. Body partimage 301 includes a symbol identifying a cancerous lesion found on thefront wall of the colon. Symbols representative of diagnosis or otherclinical finding may change over time. For example, a lesion mayinitially be classified by a clinician as precancer. Later in time, thelesion may be reclassified as cancer. A body part image may includesymbols that show the evolution of clinical findings associated with thelesion. For example, the different diagnoses associated with a lesionmay each form a layer that may be overlaid on a single body part image.The clinician or other user may select which layers (for example basedon date) may be overlaid on the body part image.

Such tools for overlaying diagnoses associated with a body location alsoallow clinician to easily differentiate between new clinical findingsand recurrences of prior clinical findings. For example, if a newclinical finding is made in a location that was previously associatedwith different finding, the new finding may be classified as arecurrence.

Body part images 303 and 305 show views of the colon that are differentfrom the view of the colon shown by body part image 301. Body part image303 and 305 represent a back view of the colon. Body part images 303 and305 include a symbol identifying a cancerous lesion found on the backwall of the colon.

A user may generate body part images 303 and 305 by selecting body partimage 301. The user may select body part image 301 by clicking a mouse,using a touch screen monitor, or by any other suitable methods. The usermay then rotate, pan, tilt and/or flip body part image 301 to createbody part images 303 and 305.

Body part images 303 and 305 are illustrative views of a colon that maybe generated by a user. Any other suitable image of a colon may begenerated by a user by rotating, panning, tilting and/or flipping bodypart image 301.

In some embodiments, the mapping tool may display different views of thecolon, in addition to information identifying biopsies and/or diagnosesassociated with the different views of the colon, independent of userselections. In some embodiments, the mapping tool may superimposediagnoses on associated with a colonoscopy, endoscope or other suitablevideo material (such as video captured by an ingested “video pill”).

FIGS. 4A-4B shows an illustrative dermatopathology report generated bythe mapping tool. The illustrative report includes information 401.Information 401 details a patient's information, specimen information,and surgery/physician information.

The illustrative report also includes diagnosis information. Diagnosisinformation is displayed in text box 403, text box 405 and text box 407.Text box 403 includes text detailing the diagnosis of lesion A found onthe patient. Text box 405 includes text detailing the diagnosis oflesion B found on the patient. Text box 407 includes text detailing thediagnosis of lesion C found on the patient.

The illustrative report also includes body part image 409. Body partimage 409 illustrates the location, on the body, where lesions A, B andC were found. This information is displayed by overlaying the letters A,B and C on the area of the body part image where the lesions were found.Letters A, B and C may represent lesions examined on different dates.Letters A, B and C may represent lesions examined on different dates bydifferent laboratories. In other embodiments, a symbol representing adiagnosis of each lesion may be overlaid on the location where thelesions were found.

The illustrative report also includes photomicrograph 411,photomicrograph 413 and photomicrograph 415. Photomicrograph 411displays a photograph of lesion A. Photomicrograph 413 displays aphotograph of lesion B. Photomicrograph 415 displays a photograph oflesion C.

The illustrative report further includes color keys 417. Color keys 417displays a plurality of symbols that may be included on an illustrativereport generated by the mapping tool. Color keys 417 include textdetailing a diagnosis associated with each of the color keys.

FIG. 5 shows an illustrative GUI 500 that may be generated by themapping tool. GUI 500 includes body part image 503, body part image 504and body part image 505. Body part image 503 includes biopsy informationfor a patient during the current year. Body part image 504 includesbiopsy information from the patient during the past two years. Body partimage 505 includes all biopsy information for the patient.

Body part image 505 includes a plurality of overlapping symbols on theface portion of the body part image. The mapping tool has generated anarrow pointing to the overlapping symbols. The mapping tool has alsodisplayed the number ‘3’ next to the arrow. The number 3 is a number ofsymbols that are overlapping on the face portion of the body part imageat the displayed zoom level of GUI 500.

GUI 500 includes legend 502. Legend 502 may display symbols that may beused by the mapping tool to illustrate a diagnosis of a biopsy. Legend502 may also display a diagnosis associated with each symbol displayedon a body part image.

A user has placed a mouse next to a plurality of overlapping symbolsdisplayed on body part image 505. Placement of the mouse next to theoverlapping symbols may generate one or both of pop up box 521 and popup box 523. Box up box 521 and pop up box 523 illustrate an enlargedview of a portion of the body part image. The portion of the body partimage includes the symbols that were at least partially overlapping inimage 505.

GUI 500 includes a plurality of options that may be selected by a userto generate one or more reports. Selection of the plurality of optionsmay be used refine data displayed for the patient. Selection of theplurality of options may be used to generate new images including datafor a different patient or for a plurality of patients. Selection ofdifferent options may instruct the mapping tool to generate an imagebased on different sources of medical information.

The plurality of options included on GUI 500 include search criteria501, search by date 507, quick date search 509, search by category 511,choose age 513, age range 515, show 517 and show hot spots 519.

FIG. 6 shows a portion of an illustrative report that may be generatedby the mapping tool. The illustrative report includes a patient'sbiopsies taken between Dec. 3, 2011, and Mar. 4, 2014. The illustrativereport includes body part image 601. Symbols identifying lesions anddiagnosis of lesions found on the patient between Dec. 3, 2001, and Mar.4, 2014, are overlaid on body part image 601. Legend 603 includessymbols that may be displayed by the mapping tool and a diagnosisassociated with each of the symbols.

Three symbols are overlaid on body part image 601. A portion of each ofthe three symbols overlaps a portion of another one of the threesymbols. In some cases, each of the three symbols may completely overlapeach other. The illustrative report includes an arrow pointing to theoverlapping symbols. The illustrative report also displays a number 3next to the arrow. The number 3 represents the number of overlappinglesions found on the patient.

The illustrative report also includes zoom-in view 605. Zoom-in view 605may be initially included in the report, or may be displayed upon userselection of the overlapping area, the number 3, or any other suitableselection. Zoom-in view 605 displays an enlarged image of the portion onbody part image 601 where the overlapping symbols are displayed.

FIG. 7 shows one or more portions of one or more illustrative reportsthat may be generated by the mapping tool. FIG. 7 includes body partimage 701 and body part image 703. Body part image 701 includes acircular symbol. The circular symbol is associated with a cancerdiagnosis (as shown in legend 707). The circular symbol is overlaid onbody part image 701 at the location where a cancerous lesion was foundon a patient on Mar. 3, 2010.

Body part image 703 also includes a circular symbol. The circular symbolis overlaid on body part image 703 at the location where a cancerouslesion was found on the patient on Dec. 6, 2013.

FIG. 7 also includes body part image 705. Body part image includes thesymbol displayed on body part image 701 and the symbol displayed on bodypart image 703. In some embodiments, body part image 705 may bedisplayed by a user by choosing the option ‘ALL’ in the drop down box711.

Body part image may include a recurrence alert symbol. The recurrencealert symbol is displayed on body part image 705 and surrounds the twooverlapping cancer symbols. The mapping tool may generate the recurrencealert based at least in part on the proximity of the two cancer symbolsto each other, a type of cancer diagnosis associated with each of thelesions, a two dimension width and/or a three dimensional depth of eachof the lesions, medical research and any other suitable information. Arecurrence alert may be generated based on clinical findings in thevicinity of previous diagnosis. In some embodiments, the proximity thatmay trigger a recurrence alert may be customized by a user of themapping tool.

Recurrence alerts generated by the mapping tool may indicate to aphysician that preventative steps should be taken. In the past, it hasbeen difficult in clinical practice and as noted in publications todetermine if a lesion is a new cancer or a recurrence. This sequentialmapping recurrence alert can help solve this difficult problem byallowing for better analysis of the success or failure of a particulardevice or surgical technique.

A mouse has been placed in close proximity to the recurrence alert. Insome embodiments, the placement of the mouse next to the recurrencealert has generated chart 709. In other embodiments, chart 709 has beengenerated together with body part image 705.

Chart 709 includes details for each of the two lesions. The detailsinclude a date of service, a diagnosis and a treatment.

FIG. 7 also includes legend 707. Legend 707 identifies a diagnosis oralert associated with symbols that may be displayed by the mapping toolon one or more reports.

FIG. 8 shows an illustrative visual report that may be generated by themapping tool. The illustrative report includes an example of a reportgenerated by the mapping tool using hot spot mapping. The hot spotmapping shown in the illustrative report was generated based on thefollowing user-selected criteria: in choose date range box 807, a daterange of Jan. 1, 2003-Dec. 31, 2012 was selected, in choose county 809,the county of queens was selected, in choose category box 811, cancerwas selected, and in choose biopsy site 813, the face was selected.

The results of the user-defined search may be output, by the mappingtool, on one or both of body part image 801 and body part image 803.Each of body part image 801 and body part image 803 are sectioned intoquadrants. As shown, body part image 801 includes data associated withthe date range from Jan. 1, 2003-Dec. 31, 2005 based on medicalinformation associated with a population that numbers 12,000. As shown,body part image 803 includes data associated with the date range fromJan. 1, 2006-Dec. 31, 2012 based on medical information associated witha population that numbers 23,555.

The quadrants may be based on ICD-9 body part descriptions or other ICDspecifications (such as nos. 10 or 11) criteria stored in the mappingtool. Some of the quadrants in body part images 801 and 803 are shaded.

Legend 805 correlates the shading, or lack of shading, of a quadrant toa number of cancer lesions found in the quadrant based on populationdata stored in a database accessible to the mapping tool. In someembodiments, body part image 308 may be generated in response to aselection of the black shading detailed on Legend 805.

Additional details of the results of the user-defined search are foundon portion 815 of the report.

FIG. 9 illustrates diagram and photo fusion routine 900 executed by themapping tool. Photo fusion routines executed by the mapping tool, such aroutine 900, may be utilized for a colonoscopy, endoscopy, orradiographic images. Routine 900 may include receiving photograph 901.Photograph 901 may represent a photograph of a patient taken on Jan. 14,2009. The patient may have darkened skin area 917 on the upper rightcheek.

Routine 900 may then include using image recognition software toidentify match points on body part image 903. Routine 900 maysubsequently include overlaying body part image 903 on top of photograph901 by aligning the identified match points with corresponding featuresin photograph 901. Image 905 shows photograph 901 with body part image903 overlaid on top of photograph 901.

Once body part image 903 is overlaid on photograph 901, the location ofdarkened skin area 917 may be automatically plotted onto body part image903. After the plotting, routine 900 may include generating body partimage 907. Body part image 907 may include a symbol representingdarkened skin area 917.

Routine 900 may further include integrating body part image 909 withbody part image 907 and/or photograph 901. Body part image 909 mayinclude a symbol overlaid on body part image 909. The symbol representsa lesion found on the patient on May 20, 2011.

The integration of body part image 909 with photograph 901 may generatehybrid photograph-image 911. Hybrid photograph-image 911 may includephotograph 901, without the darkened skin region. Overlaid on top ofphotograph 901 may be an outline of body part image 909. Two symbols mayalso be overlaid on top of photograph 901. The triangular symbol mayrepresent the lesion found on the patient on Jan. 14, 2009. The circularsymbol may represent the lesion found on the patient on May 20, 2011.

The integration of body part image 909 with body part image 907 maygenerate body part image 913. Body part image 913 may include atriangular symbol and a circular symbol. The triangular symbol mayrepresent the lesion found on the patient on Jan. 14, 2009. The circularsymbol may represent the lesion found on the patient on May 20, 2011.

The mapping tool may display legend 915 next to each of hybridphotograph-image 911 and body part image 913. Legend 915 may includesymbols used by the mapping tool and a diagnosis associated with each ofthe symbols.

FIG. 10 shows an illustrative report that may be generated by themapping tool. The illustrative report may have been generated inresponse to the following user selections: in choose date range 1103, aselection of the date range Jan. 1, 2003 to Dec. 31, 2012, in chooselabs 1005, a selection of ALL. An additional user-selection (notdisplayed) may include selecting ‘view discordances.’ Discordance mayrefer to a biopsy diagnosis, issued by a second lab, that differs froman opinion issued by a first lab.

In response to the user-defined selections, the mapping tool maygenerate a search and output the illustrative report. The illustrativereport may include body image 1001. Symbols may be overlaid on bodyimage 1001. Each symbol may represent medical information generated byone of labs ABC, BBB and ZZZ. Each symbol overlaid on body image 1001may represent a discordance of opinion for the associated laboratory.The discordance of opinion may be related to a biopsy taken from an areaof the body on which the symbol is overlaid. The discordance may bebetween a first lab and one of the labs ABC, BBB and ZZZ.

Body image 1001 may assist a user in visually identifying locations onthe body where discordances between labs frequently occur.

The illustrative report may also include results 1007. Results 1007 mayinclude details of the search terms and the discordances found for eachof labs ABC, BBB and ZZZ.

In some embodiments, a user may execute a selection to view thediscordances of each lab on a different body part image. In theseembodiments, the mapping tool may generate three body part images. Eachbody part image may display symbols identifying locations of lesions onthe body for which a discordance of opinion has occurred. When thediscordances of the labs are viewed side by side, a user may easilyidentify which lab has a higher discordance rate.

FIG. 11 shows an illustrative report generated by the mapping tool. Thereport may be generated in response to a user selecting: from choosedate range 1103, a date range of Jan. 1, 1993 to Dec. 31, 2013, fromchoose treatments 1105, the treatments of excision and Mohs surgery, andfrom choose outcomes 1107, the outcomes of cure and complication.

The illustrative report may include body part image 1101. Body partimage may include symbols for each of the excision and Mohs surgerytreatments performed by health practitioner between Jan. 1, 1993 andDec. 31, 2013. The symbols displayed on body part image 1101 identify alocation of each of the surgeries and whether or not the surgery curedthe problem or resulted in complications.

The illustrative report may include legend 1111. Legend 1111 mayidentify symbols used by the mapping tool to illustrate surgeries andoutcomes of the surgeries. The illustrative report may also includeresults 1109. Results 1109 may include parameters of the search and asummary of the search results.

The illustrative report generated by the mapping tool may assist a userin determining whether or not Mohs surgery has more cures and lesscomplications in comparison to excisions. The illustrative report canalso assist a user in identifying differences between Mohs and excisionsbased on body location.

FIG. 12 shows a block diagram that illustrates a computing device 1201(alternatively referred to herein as a “server or computer”) that may beused according to an illustrative embodiment of the invention. Thecomputer server 1201 may have a processor 103 for controlling overalloperation of the server and its associated components, including RAM1205, ROM 1207, input/output (“I/O”) module 1209, and memory 1215.

I/O module 1209 may include a microphone, keypad, touch screen and/orstylus through which a user of device 1201 may provide input, and mayalso include one or more of a speaker for providing audio output and avideo display device for providing textual, audiovisual and/or graphicaloutput. Software may be stored within memory 1215 and/or other storage(not shown) to provide instructions to processor 1203 for enablingserver 1201 to perform various functions. For example, memory 1215 maystore software used by server 1201, such as an operating system 1217,application programs 1219, and an associated database 1211. Memory 1215may store software used by server 1201 to render images, overlay medicalinformation or perform any suitable function of the mapping tool.Database 1211 may include a plurality of distributed databases.Alternatively, some or all of computer executable instructions of server1201 may be embodied in hardware or firmware (not shown).

Server 1201 may operate in a networked environment supportingconnections to one or more remote computers, such as terminals 1241 and1251. Terminals 1241 and 1251 may be personal computers or servers thatinclude many or all of the elements described above relative to server1201. The network connections depicted in FIG. 12 include a local areanetwork (LAN) 1225 and a wide area network (WAN) 1229, but may alsoinclude other networks. When used in a LAN networking environment,computer 1201 is connected to LAN 1225 through a network interface oradapter 1213. When used in a WAN networking environment, server 1201 mayinclude a modem 1227 or other means for establishing communications overWAN 1229, such as Internet 1231.

It will be appreciated that the network connections shown areillustrative and other means of establishing a communications linkbetween the computers may be used. The existence of any of variouswell-known protocols such as TCP/IP, Ethernet, FTP, HTTP and the like ispresumed, and the system can be operated in a client-serverconfiguration to permit a user to retrieve web pages from a web-basedserver. Any of various conventional web browsers can be used to displayand manipulate data on web pages.

Additionally, application program 1219, which may be used by server1201, may include computer executable instructions for invoking userfunctionality related to communication, such as email, short messageservice (SMS), and voice input and speech recognition applications.

Computing device 1201 and/or terminals 1241 or 1251 may also be mobileterminals including various other components, such as a battery,speaker, and antennas (not shown). Terminal 1251 and/or terminal 1241may be portable devices such as a laptop, tablet, smartphone or anyother suitable device for receiving, storing, transmitting and/ordisplaying relevant information.

Any information described above in connection with database 1211, andany other suitable information, may be stored in memory 1215. One ormore of applications 1219 may include one or more algorithms used by themapping tool that may be used to receive historical data, determine aposition of the historical data on a body part image, identifyoverlapping data points, assign a color and/or shape to a data point,filter data points, translate written anatomical descriptions into apoint or area on a body part image and/or any other suitable tasks.

The invention may be operational with numerous other general purpose orspecial purpose computing system environments or configurations.Examples of well-known computing systems, environments, and/orconfigurations that may be suitable for use with the invention include,but are not limited to, personal computers, server computers, hand-heldor laptop devices, tablets, mobile phones and/or other personal digitalassistants (“PDAs”), multiprocessor systems, microprocessor-basedsystems, set top boxes, programmable consumer electronics, network PCs,minicomputers, mainframe computers, distributed computing environmentsthat include any of the above systems or devices, and the like.

The invention may be described in the general context ofcomputer-executable instructions, such as program modules, beingexecuted by a computer. Generally, program modules include routines,programs, objects, components, data structures, etc. that performparticular tasks or implement particular abstract data types. Theinvention may also be practiced in distributed computing environmentswhere tasks are performed by remote processing devices that are linkedthrough a communications network. In a distributed computingenvironment, program modules may be located in both local and remotecomputer storage media including memory storage devices.

FIG. 13 shows illustrative apparatus 1300. Apparatus 1300 may be acomputing machine. Apparatus 1300 may include one or more features ofthe apparatus shown in FIG. 13. Apparatus 1300 may include chip module1302, which may include one or more integrated circuits, and which mayinclude logic configured to perform any other suitable logicaloperations.

Apparatus 1300 may include one or more of the following components: I/Ocircuitry 1304, which may include a transmitter device and a receiverdevice and may interface with fiber optic cable, coaxial cable,telephone lines, wireless devices, PHY layer hardware, a keypad/displaycontrol device or any other suitable encoded media or devices;peripheral devices 1306, which may include counter timers, real-timetimers, power-on reset generators or any other suitable peripheraldevices; logical processing device 1308, which may compute datastructural information, structural parameters of the data, quantifyindices; and machine-readable memory 1310.

Machine-readable memory 1310 may be configured to store inmachine-readable data structures: historical sequential data and anyother suitable information or data structures.

Components 1302, 1304, 1306, 1308 and 1310 may be coupled together by asystem bus or other interconnections 1312 and may be present on one ormore circuit boards such as 1320. In some embodiments, the componentsmay be integrated into a single chip. The chip may be silicon-based.

FIGS. 14A-14I show an illustrative algorithm for plotting historicaldata on a body part image and displaying the historical data overlaid onthe anatomical diagram.

FIG. 14 shows illustrative process 1400. For the sake of illustration,one or more of the steps of the process illustrated in FIG. 14 will bedescribed as being performed by a “system.” The “system” may be themapping tool, and may include one or more of the features of theapparatus, arrangements, information or processes shown in FIGS. 12-13and/or any other suitable device or approach. The “system” may beprovided by an entity. The entity may be an individual, an organizationor any other suitable entity.

Process 1400 includes various steps shown in section 14A. The Stepsshown in section 14A include locating patient information based on asubmitted query. The patient information may be stored in a centraldatabase as part of an electronic medical record (EMR) associated withthe patient. The query may include inputs such as an accession number,date range, category of diagnosis or any suitable input. The Steps shownin section 14A may parse a submitted query and identify criteria thatmay be used to identify desired biopsy marker records. Each biopsymarker record may correspond to a medical procedure that was performedon the patient associated with the accession number input.

Steps in section 14B include obtaining marker records requested incriteria parsed from the query. The steps in section 14B also identifybody part images associated with each marker record. For example, somemarker records may be associated with a patient's head. Other markerrecords may be associated with the patient's foot. The query may requestall different marker records associated with the patient entire bodyover a period of time. In other examples, the query may request markerrecords associated with a particular organ or body part.

Each marker record may include a diagnosis code and a body location.Each body location may be associated with a body part image. For eachretrieved marker record, the steps in section 14B include identifyingmarker records that point to identify or substantially overlappinglocations on a body part image.

The steps in section 14D-14E include loading body part images associatedwith the retrieved marker records and plotting the diagnosis associatedwith each marker record. Each diagnosis may be associated with adifferent symbol, color or other visual indicator. A size and shape of avisual indicator may depend on the diagnosis. For example, for adiagnosis of cancer—the symbol may be larger and otherwise moreprominent than if the diagnosis were benign.

The steps in section 14F may include managing the plotting ofoverlapping visual markers. For example, a patient may have had two ormore biopsy locations (identified in two or more marker records) thatare each associated with the substantially identical X,Y coordinate on abody part image. To indicate that a single location may be associatedwith two or more diagnoses, the steps in section 14F include drawing anarrow pointing to an overlapping location. The steps in section 14F mayalso include other indicators, such as text, that indicate thatadditional marker records have been plotted but are not currentlyvisible. A user may need to scroll or rotate or otherwise manipulate animage to view each of the additional diagnoses associated with the twoor more marker records.

The steps in section 14H include amalgamating the various body partimages and plotted diagnoses. For example, a height and width of a bodypart image may be adjusted. Each of the body part images that include atleast one plotted diagnoses may be combined to create a view of acomplete human body.

The process shown in section 14I includes a high level overview of theflow of the process detailed in sections 14A-14H.

FIG. 15 shows another illustrative algorithm for plotting historicaldata on a body part image. The illustrative algorithm displayed in FIG.15 may include returning a final image after completing to process theimage. The final image may be generated using an algorithm detailed inFIG. 14 or any other suitable algorithm.

The final image may include one or more features or functionalitiesdetailed in FIG. 15.

FIG. 16 shows illustrative body part images that may be stored andretrieved by the mapping tool. The mapping tool may display one or moreof the illustrated body part images on one or more reports incombination with one or more pieces of historical medical information.

Thus, apparatus and methods for plotting pathological diagnoses onanatomical diagrams are provided. Persons skilled in the art willappreciate that the present invention can be practiced in embodimentsother than the described embodiments, which are presented for purposesof illustration rather than of limitation.

What is claimed is:
 1. A visual mapping tool for anatomically plotting apathological diagnosis, the tool comprising a non-transitorycomputer-readable medium, comprising instructions stored thereon, theinstructions when executed on a processor, perform the steps of:identifying a plurality of biopsy marker records that include thepathological diagnosis; retrieving a body part image linked to eachbiopsy marker record; determining a location on the body part image forthe pathological diagnosis of each biopsy marker record; formulating arecurrence alert based on: a distribution of the locations across thebody part image; and 1D, 2D or 3D measurements associated with thepathological diagnosis of each biopsy marker record; and generating adisplay on a graphical user interface, the display including: therecurrence alert; and identification of overlapping locations on thebody part image.
 2. The visual mapping tool of claim 1 wherein theformulating of the recurrence alert further comprises, for a lesionbiopsied at each location: a size of the lesion relative to sizes oflesions biopsied at other locations; a volume of the lesion relative tovolumes of lesions biopsied at the other locations; a distance betweenthe lesion and the lesions biopsied at the other locations; or a size orvolume of the lesion relative to pre-established measurements associatedwith the pathological diagnosis.
 3. The visual mapping tool of claim 2wherein the formulating of the recurrence alert further comprisesdetermining whether measurements associated with the lesion biopsied ateach location are correlated with recurrence of the pathologicaldiagnosis.
 4. The visual mapping tool of claim 1 wherein thepathological diagnosis is selected from a group consisting of melanoma,basal cell carcinoma, and squamous cell carcinoma.
 5. The visual mappingtool of claim 1 wherein the display comprises shading of the body partimage based on: the distribution of the locations; and ICD-9 body partcoding.
 6. The visual mapping tool of claim 1 wherein the body partimage depicts a prostrate, an upper gastrointestinal tract or a lowergastrointestinal tract.
 7. The visual mapping tool of claim 1 whereinthe body part image is a three dimensional image.
 8. Acomputer-implemented method for anatomically plotting pathologicaldiagnoses on a body part image, the method comprising using a computerprocessor to perform the steps of: running a first query to retrieve,from a database, a plurality of biopsy marker records that include anaccession number; in response to receiving the plurality of biopsymarker records, running a second query to return a body part imageassociated with each of the plurality of biopsy marker records;iterating through the plurality of biopsy marker records to identify afirst biopsy location associated with a first biopsy marker record and asecond biopsy location associated with a second biopsy marker record,the second biopsy location being within a predetermined distance on thebody part image from the first biopsy location; identifying a recurrencearea on the body part image, the recurrence area including the firstbiopsy location and the second biopsy location; and generating a displayon a graphical user interface, the display including; the body partimage; a first symbol identifying a first pathological diagnosisassociated with the first biopsy marker record; a second symbolidentifying a second pathological diagnosis associated with the secondbiopsy marker record; and a recurrence alert symbol identifying therecurrence area on the body part image; wherein the body part image isselected from a group consisting of a prostrate, an uppergastrointestinal tract and a lower gastrointestinal tract.
 9. Thecomputer-implemented method of claim 8 wherein the recurrence area isdetermined based on one or more attributes associated with the first andsecond biopsy locations, the attributes selected from a group consistingof: a proximity of the first and second biopsy locations to each other;a type of cancer diagnosis associated with first and second biopsylocations; length, width and depth of a first lesion biopsied at thefirst biopsy location; and length, width and depth of a second lesionbiopsied at the second biopsy location.
 10. The computer-implementedmethod of claim 8 further comprising querying a symbol record toidentify: the first symbol associated with the first pathologicaldiagnosis stored in the first biopsy marker record; and the secondsymbol associated with the second pathological diagnosis stored in thesecond biopsy marker record.
 11. The computer-implemented method ofclaim 8 further comprising: querying a color record to identify a colorassociated with the first symbol and a color associated with the secondsymbol; and displaying, on the body part image, the first symbol in thefirst color and the second symbol in the second color.
 12. Thecomputer-implemented method of claim 8 wherein the display is a firstdisplay, the method further comprising generating a second display ofthe body part image, the second display including a third pathologicaldiagnosis overlaid on the body part image; wherein the thirdpathological diagnosis is not visible in the first display.
 13. Thecomputer-implemented method of claim 8 further comprising: receivingdata identifying a cursor within a threshold proximity to the recurrencealert symbol; and in response to detecting the cursor within thethreshold proximity to the recurrence alert symbol, displaying datastored in the first biopsy marker record and data stored in the secondbiopsy marker record, the displayed data including a date of service, adiagnosis and a treatment.
 14. The computer-implemented method of claim8 further comprising determining the recurrence area based on: a firstpair of X,Y coordinates associated with the first biopsy marker record;a second pair of X,Y coordinates associated with the second biopsymarker record; the first pathological diagnosis stored in the firstbiopsy marker record; and the second pathological diagnosis stored inthe second biopsy marker record.
 15. The computer-implemented method ofclaim 8 further comprising identifying the recurrence area based on: afirst pair of X,Y,Z coordinates associated with the first biopsy markerrecord; a second pair of X,Y,Z coordinates associated with the secondbiopsy marker record; the first pathological diagnosis stored in thefirst biopsy marker record; and the second pathological diagnosis storedin the second biopsy marker record.
 16. A computer-implemented methodfor anatomically plotting pathological diagnoses on a body part image,the method comprising executing on a processor the steps of: retrievinga plurality of biopsy marker records that include an accession number;retrieving a body part image associated with the plurality of biopsymarker records; iterating through the plurality of biopsy marker recordsto identify at least one first set of coordinates identifying a firstlocation associated with a first biopsy marker record spaced apredetermined distance apart from a second set of coordinatesidentifying a second location associated with a second biopsy markerrecord; identifying a recurrence location of a pathological disease, therecurrence location including the first set of coordinates and thesecond set of coordinates; and generating a display on a graphical userinterface, the display including: a first symbol at the first location;a second symbol at the second location; and a recurrence alert symboloverlaid on the body part image, the recurrence alert symbol identifyingthe recurrence location on the body part image and circumscribing thefirst symbol and the second symbol; wherein: the first set ofcoordinates and the second set of coordinates are each X,Y,Zcoordinates; and the body part image is a three-dimensional image. 17.The computer-implemented method of claim 16 further comprising:identifying the first symbol based on a first pathological diagnosisstored in the first biopsy marker record; identifying the second symbolbased on a second pathological diagnosis stored in the second biopsymarker record; and displaying, on the body part image included on thegraphical user interface, the first symbol in a first color and thesecond symbol in a second color.
 18. The computer-implemented method ofclaim 16 wherein the generating the display further comprisingpresenting the body part image in a transparent form such that a frontand a back portion of the body part image are visible simultaneously.19. The computer-implemented method of claim 16 wherein the display is afirst display, the method further comprising: receiving a user selectionof the body part image; and in response to the user selection,displaying a second display of the body part image, the second displayincluding a third pathological diagnosis overlaid on the body partimage; wherein the third pathological diagnosis is not visible in thefirst display.
 20. The computer-implemented method of claim 16 furthercomprising: receiving data identifying a cursor positioned within athreshold proximity to the recurrence location; and in response todetecting the cursor positioned within the threshold proximity to therecurrence location, displaying data stored in the first biopsy markerrecord and data stored in the second biopsy marker record, the displayeddata including a date of service, a diagnosis and a treatment.
 21. Thecomputer-implemented method of claim 16 further comprising generatingthe recurrence alert symbol based on customized criteria entered by auser of the graphical user interface.